Physicians United Medicare Advantage Plan Being Liquidated

Published: Monday, June 9, 2014 at 4:02 p.m.

Last Modified: Tuesday, June 10, 2014 at 12:22 a.m.

LAKELAND | Physicians United Plan, a Medicare Advantage plan with members in Polk and 16 other Florida counties, is in the process of being closed.

A circuit judge in Leon County has approved having the state take over the plan and liquidate it. State officials said the plan is insolvent.

PUP officials said last fall the plan had almost 11,000 members in Polk County, A company spokesman hadn't returned a call and an e-mail asking for more current figures and other information as of 8 p.m. Monday.

A Florida Department of Financial Services spokeswoman said the plan has about 50,000 members statewide.

Plan members will go into original Medicare and be assigned to a Medicare Part D prescription drug plan once PUP ends, according to federal Centers for Medicare and Medicaid Services officials.

Closing is expected to happen by July 1.

They would be able to enroll in another Medicare Advantage plan and/or another Part D plan during the annual Medicare open enrollment from Oct. 15 to Dec. 7 if they don't want to remain in original Medicare and the Part D plan they are put in.

The Center for Medicare and Medicaid Services also has the option of holding a special enrollment period to let them get into other plans more quickly.

PUP is the Medicare HMO that in 2011 dropped Clark & Daughtrey Medical Group from its list of health care providers, affecting more than 1,000 Polk residents on PUP whose doctors were at Clark & Daughtrey.

PUP parted ways with Bond Clinic last year, effective Dec. 1, when the clinic and the plan were unable to reach agreement on contract terms.

PUP had 25,127 clients statewide in its plan in 2012, according to a Health Market Review analysis by analyst Allan Baumgarten, who said that was an almost 100 percent increase from the previous year.

As recently as February, PUP was publicizing itself as the fastest-growing health plan in the state.

Some Polk County doctors' offices have told The Ledger that payments from the plan, which began in July 2005, became slow this year.

"The issue here is con­tinuity of care for patients," said Dr. Stuart Patterson of Central Florida Orthopaedic Surgery Associates in Lakeland.

"Institutions are already turning PUP patients away," he added. "I have had to cancel PUP patients who were scheduled for surgery this week."

PUP signed an agreement in April in which its directors admitted that, unless it got an infusion of $30 million by noon on June 3, grounds would exist for appointing the Department of Financial Services to rehabilitate or liquidate it.

PUP notified the state on May 8 it would be getting that capital.

A financial statement the state received on May 27, however, showed PUP with a deficit of almost $13 million, according to an affidavit by the director of life and health financial oversight for the Office of Insurance Regulation.

And, on June 3, PUP said it wouldn't be able to get the money, triggering the state's motion to move toward liquidating the plan.

PUP's telephone num- ber is 866-571-0693. A recording on that line said members might be receiving a survey from the Center for Medicare and Medicaid Services.

[ Robin Williams Adams can be reached at robin.adams@theledger.com or 863-802-7558. Read her blog at robinsrx.blogs.theledger.com. Follow on Twitter @ledgerROBIN. ]

<p>LAKELAND | Physicians United Plan, a Medicare Advantage plan with members in Polk and 16 other Florida counties, is in the process of being closed.</p><p>A circuit judge in Leon County has approved having the state take over the plan and liquidate it. State officials said the plan is insolvent.</p><p>PUP officials said last fall the plan had almost 11,000 members in Polk County, A company spokesman hadn't returned a call and an e-mail asking for more current figures and other information as of 8 p.m. Monday.</p><p>A Florida Department of Financial Services spokeswoman said the plan has about 50,000 members statewide.</p><p>Plan members will go into original Medicare and be assigned to a Medicare Part D prescription drug plan once PUP ends, according to federal Centers for Medicare and Medicaid Services officials.</p><p>Closing is expected to happen by July 1.</p><p>They would be able to enroll in another Medicare Advantage plan and/or another Part D plan during the annual Medicare open enrollment from Oct. 15 to Dec. 7 if they don't want to remain in original Medicare and the Part D plan they are put in. </p><p>The Center for Medicare and Medicaid Services also has the option of holding a special enrollment period to let them get into other plans more quickly.</p><p>PUP is the Medicare HMO that in 2011 dropped Clark & Daughtrey Medical Group from its list of health care providers, affecting more than 1,000 Polk residents on PUP whose doctors were at Clark & Daughtrey.</p><p>PUP parted ways with Bond Clinic last year, effective Dec. 1, when the clinic and the plan were unable to reach agreement on contract terms. </p><p>PUP had 25,127 clients statewide in its plan in 2012, according to a Health Market Review analysis by analyst Allan Baumgarten, who said that was an almost 100 percent increase from the previous year.</p><p>As recently as February, PUP was publicizing itself as the fastest-growing health plan in the state.</p><p>Some Polk County doctors' offices have told The Ledger that payments from the plan, which began in July 2005, became slow this year.</p><p>"The issue here is con­tinuity of care for patients," said Dr. Stuart Patterson of Central Florida Orthopaedic Surgery Associates in Lakeland.</p><p>When insurance com­panies failed in the past, patients had trouble getting care in "a timely fashion," Patterson said. </p><p>"Institutions are already turning PUP patients away," he added. "I have had to cancel PUP patients who were scheduled for surgery this week." </p><p>PUP signed an agreement in April in which its directors admitted that, unless it got an infusion of $30 million by noon on June 3, grounds would exist for appointing the Department of Financial Services to rehabilitate or liquidate it.</p><p>PUP notified the state on May 8 it would be getting that capital. </p><p>A financial statement the state received on May 27, however, showed PUP with a deficit of almost $13 million, according to an affidavit by the director of life and health financial oversight for the Office of Insurance Regulation. </p><p>And, on June 3, PUP said it wouldn't be able to get the money, triggering the state's motion to move toward liquidating the plan. </p><p>PUP's telephone num- ber is 866-571-0693. A recording on that line said members might be receiving a survey from the Center for Medicare and Medicaid Services. </p><p>[ Robin Williams Adams can be reached at robin.adams@theledger.com or 863-802-7558. Read her blog at robinsrx.blogs.theledger.com. Follow on Twitter @ledgerROBIN. ]</p>